As a registered nurse, personal trainer, and an athlete, I believe exercise is a key component to overall health. Just as real food is medicine, exercise is medicine too! Besides its positive effects on body composition, functional ability, strength, cardiovascular fitness, and nearly every system of the body, exercise also acts as an immune-enhancer by releasing endorphins and other neurotransmitters that modulate immune function. Even though exercise is clearly important for everyone, it can be especially difficult for those with autoimmune disease.
I have to be honest and admit that my personal experience is this subject is still a bit of a sore spot for me. Having been an athlete my entire life, it's a huge part of how I identify myself. For many years, I've maintained workouts 6-7 days/week for 2-3hours/day. Not because I felt like I had to, but because I just really love it. I love the feeling of the runner's high after a hard endurance run. I equally love the good burn after hitting the heavy weights in the gym. Before I was ill earlier this year, I would feel extremely out-of-whack if I missed a workout. I've often jokingly admitted that I'm addicted to exercise, but there is definitely truth to that statement.

However, this year has been quite a defining year for me and I've begun to realize that although the right amount of exercise is a wonderful thing, too much exercise can be harmful. When you add autoimmune disease into the mix, it becomes even more necessary to find balance in all areas of your life, including physical activity and fitness. I am currently trying to work on that aspect of my life and it's been very difficult for me. But let me back up a bit...

Earlier this year, I was training for a summer marathon. This was the year that I was finally going to get back into long distance running. About 5 years ago, I injured myself in a race. I tore the vastus medialis in my left leg, one of the muscles that comprises the quadriceps and helps to control movement of the knee. I went through multiple rounds of physical therapy over several years, but still had pain and discomfort. The doctors were stumped because the repeat MRIs showed nothing structurally wrong that would be causing the pain. To this day, my leg/knee still hurts, but earlier this year I had decided that it had likely improved as much as it was going to and I wasn't letting it stop me from running the marathon. A recent visit to a rheumatologist has finally unlocked the mystery to this and several other injuries that I've had that just won't heal. The rheumatologist diagnosed me with enthesitis, which is a painful inflammation of the sites where tendons and ligaments insert into the bone. Enthesitis is often caused by autoimmune disease.

But months before that diagnosis, there I was training for the marathon and I felt pretty good. I signed up for several short and mid-distance races to keep me on track with my training and I was having a great time. In between the running, I was lifting weights, cycling, swimming, and Crossfitting. Then one day, I tripped, fell down the stairs, and badly sprained my ankle. I still have not fully recovered from this injury due to the enthesitis that has set into the ankle tendon insertion sites. A few weeks after the ankle sprain, I started getting very ill. Because I had no idea what was going on with my body, I kept pushing through my workouts. I wasn't running at that time due to my ankle, but I was still lifting heavy weights, cycling, and swimming. It wasn't until I was officially diagnosed that I realized just how bad I felt and I admitted to myself that I couldn't keep up with my workout schedule anymore. I have a small personal training business on the side and I finally had to make the decision to call my clients and put them on hold. I wasn't well enough to train other people, let alone myself.

Most people would have completely stopped working out at that point, but I was holding on. I cut back my workouts to 3-4 days/week. I stopped all cardio, except for an indoor cycling class that I attended once a week. Long, sustained cardio sessions are typically not the best choice for a person with IBD. I made a half-hearted attempt to keep up with my weightlifting, but it just wasn't the same. I was mostly going through the motions in an effort to maintain some semblance of normality. I would go to the gym and become frustrated and depressed because my entire body hurt and my joints were aching (I've since discovered that I also have inflammatory arthritis, which may or may not be related to IBD). I felt like I had been hit by a train. I once described it as waking up everyday and feeling like I had the flu. Except it never went away. I lost quite a bit of weight. I was fatigued with a tiredness that I felt to the bone. It was a challenge to get out of bed everyday and make it to work. Part of this extreme fatigue is due to the nature of the autoimmune disease that I have and part may be due to the adrenal fatigue that I'm dealing with on top of everything else.

At some point, I realized that I needed to take a real break from the gym. My body was just not going to let me go on like this. For about a month, I completely put my workouts on hold. I still maintained some physical activity in that I continued to get out and walk my dog everyday, even if only for a short distance. After that month was over, I was feeling much better. My GI symptoms were under control due to the healing dietary changes. I was still having some joint pain and fatigue, but not quite as bad as previously. It does continue to be a struggle, but I'm hopeful that the diet and other alternative treatments I'm using will continue to alleviate these lingering symptoms.

Since learning that I'm suffering from adrenal fatigue, I've made some changes to my gym routine now that I'm back at the gym. I am still avoiding cardio sessions. I am lifting weights, but I'm limiting my workouts to 4 days/week and a maximum of an hour in length. I've made an effort to incorporate a lot more yoga into my routine. I'm trying to listen to my body more. If I'm not feeling good, I don't push it. There have been a few workouts recently that I really felt ready for more (I am really, really missing Crossfit), but I know that I'm not quite ready for it yet. It's a work in progress...it remains very difficult for me to admit that I'm not 100%, like I was in this photo taken during a tough Crossfit workout only last year:

I am not disheartened though; I know that I will get back to my former self!

I realize that many people with autoimmune disease have a different sort of challenge than me. For me, it's a challenge not to ignore my body and push too hard, but for others, it is difficult to maintain any sort of physical activity. I plan on addressing that issue and giving some tips on how to safely exercise with autoimmune disease in future posts.